The judge ruled that a non-binary Canadian’s $70,000 gender affirmation surgery would allow her to keep the pen!
According to the Ontario Superior Court documents, KS was born as a male, and he used a female pronoun, but was not determined to be completely male or completely female.
The 34-year-old, who was only identified in the abbreviation in legal filing, sued the Ontario Health Insurance Program (OHIP) in 2022 after the company refused her request to pay for the cost of building a “Neo-vagina” surgery at a Texas clinic, according to The Post Online.
She wanted to build a female organ in the gap between the scrotum and anus while also maintaining her fully functional male sexual organ.
Now, after a landmark victory in court, the brunt of $70,000 surgery and flights to the U.S. will fall on Canadian taxpayers.
Dr. Irena Druce, an endocrinologist at Ottawa Hospital, submitted a “request for pre-approval of progressive redistribution surgery” – after completing multiple assessments with mental health consultant Yael Sela, the price of KS is $10,000 to $70,000.
Together, they determined that KS “continuous gender irritability.” They said she was eligible for surgery because she had been treated with hormones for one year and was “common with the gender role for 12 consecutive months.”
This process, also known as Penile’s vaginal plasty, is available only in Texas. Reduxx said the money is not allowed in Canada, but the money will cost her to go to the United States for surgery.
The insurance company believes that the procedure cannot be publicly funded because vaginal phantoms will not be accompanied by CEN osteectomy and therefore is not a procedure listed on its welfare schedule.
The company’s appeal filed on April 22 said the process was run by President and CEO Matthew Anderson, who also believes the process is considered experimental in Ontario and is not eligible for coverage.
KS then appealed to the Health and Services Appeals and Review Board, which subsequently reversed the initial decision of OHIP, deeming that it should be covered even if CEN osteectomy is not performed.
OHIP appealed this, but failed again after the group determined the surgery – which would make her penis fully functional and create a “Neo -Vagina” in the space between her penis and anus – would be fully insured.
The province’s appeal was heard on November 26, 2024, with three judges – Benjamin Zarnett, Steve Coroza and Lise Favreau, rejecting the company’s arguments denied the denial of coverage because “the health professionals at KS neither recommended nor recommended by KS.
The Court of Appeal also said: “The existence of different techniques that perform vaginal plasty does not affect this conclusion. The drafter of the welfare schedule for each specially listed service is open to describe in a broad or narrow manner. Here, the selected description of “vaginoplasty” is broad enough to include different techniques.
They added: “No vaginal papillary without CEN osteectomy is an insurance service because it is still a vaginal papillary and is a specially listed service.”
The document says KS’s doctor said in a letter that she “identifies it as transserine, but is not entirely at the “female” end of the spectrum, so it’s important for her to have a vagina while maintaining her penis.”
It continues: “Her hope is to contribute to clinical research in the field as her career continues.”
The document says that in addition to winning the surgery, KS was awarded $23,250 by three judges.
Ontario must submit its latest ruling to the Supreme Court of Canada by June 23.
Her attorney, John McIntyre, told the National Post that his client was “satisfied” with the decision.
“KS is satisfied with the Court of Appeal’s ruling, which is now the third unanimous ruling confirming that her gender confirmation surgery is covered under the Ontario Health Insurance Act and its regulations,” McIntyre said.
